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#2997 ASSESSMENT OF FRACTURE RISK IN KIDNEY TRANSPLANT RECIPIENTS BY FRAX SCORE WITHOUT BONE MINERAL DENSITY

Nephrology Dialysis Transplantation(2023)

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Abstract Background and Aims Bone disease post-transplantation is a major cause of morbidity in kidney transplant (KT) recipients, with a significantly higher risk of fractures and mortality. This study investigated the added value of calculated 10-year fracture risk for major osteoporotic fracture (MOF) and hip fracture by frax score with an assessment of risk factors in KT recipients. Methods A cross-sectional study included 71 live-related KT recipients. Demographic, clinical, and laboratory data were recorded. The 10-year fracture risk for MOF and hip fracture were calculated using frax score without bone mineral density in recipients who completed at least 1 year after KT. Results The prevalence of MOF (>3% risk of fracture) was 14.1%(10 patients), MOF (<3% risk of fracture) was 85.9% (61 patients). A high hip fracture score (>3% risk of hip fracture) was in 10% (1 patient). There was a significant difference between both groups (>3%vs <3% fracture risk) in age, MOF score, hip fracture score, and serum albumin p-value were <0.00001, <0.00001, 0.000134, and 043009 respectively. The analysis of demographic data of the patients with a score (>3% fracture risk) showed that 70% were males (7 patients), 50% (5 patients) had BMI>30 and the main cause of ESRD pre-transplant was lupus nephritis and glomerulonephritis in 50% (5 patients) that exposed for long periods of immune suppression pre-transplant. In 80% (8 patients) were 1st transplant, 10% (1 patient) were 2nd transplant, and 10% (1 patient) was a combined liver-kidney transplant. The rejection episode was zero%. There was a significant difference in patients' fracture risk >3% in phosphorus pre-transplant versus post-transplant p-value 0.01. Conclusion Frax score without bone mineral density has shown a low percent of fracture risk (<3%) in most kidney transplant recipients and high scores were associated with high BMI, phosphorus, and exposure pre-transplant to immune suppression.
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